Deirdre W Street, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007674 Issued in NC

Practice address

15 Henderson St W
Wrightsville Beach, NC 28480-1803

Phone

(910) 233-0052

Fax

(910) 338-1300

NPI assigned

Jul 23, 2012

Reactivated

Mar 11, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deirdre W. Street, LLC

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1821346313
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1346595758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HENDERSON ST W",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801803",
            "telephone_number": "910-233-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HENDERSON ST W",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801803",
            "telephone_number": "910-233-0052",
            "fax_number": "910-338-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "DEIRDRE",
        "middle_name": "W",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "deactivation_date": "2012-09-20",
        "reactivation_date": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wrightsville Beach, NC
• Providers in Wrightsville Beach, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.